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MATERNAL AND CHILD HEALTH IN BRAZIL

Tuesday, 24th of May 2011

How many countries have seen their Gini coefficient move from 0.64 to 0.49 in their urban areas? Brazil is proof positive that state intervention can effect disparity reductions in income and services, even in traditionally inequitable societies.

Summary is at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60138-4/abstract

Full text is at http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(11)60138-4/fulltext

BD

 

Key messages

• The health and nutrition of Brazilian children has improved rapidly since the 1980s. A key indicator of Millennium Development Goal 1 (a reduction in the number of underweight children by half between 1990 and 2015) has already been met and Millennium Development Goal 4 (a two-thirds reduction in mortality rate of children younger than 5 years by 2015) will probably be met within the next 2 years.
• Progress in maternal mortality ratios is difficult to measure because time trends are distorted by improvements in vital statistics, but evidence exists of a decrease in maternal mortality ratios in the past three decades. However, Millennium Development Goal 5 (a reduction in maternal mortality by three-quarters between 1990 and 2015) will probably not be met.
• Regional and socioeconomic inequalities in intervention coverage, nutrition, and health outcomes in Brazil have largely decreased.
• The main factors that drive such trends probably include improvements in social determinants (ie, poverty, education of women, urbanisation, and fertility), non-health-sector interventions (ie, cash transfers, water, and sanitation), and the creation of a unified national health system with geographical targeting for primary health care (giving previously underserved populations better access to health care), in addition to disease-specific programmes.
• Major challenges exist, including a reduction of the high frequency of caesarean section, illegal abortions, and preterm births, in addition to achieving further reductions in regional and socioeconomic inequalities in health.